Hello! wow, it has been a big couple of weeks since our last update. Jerry, no problem - I did have a chance to see your original post before the outage, so it did get to me!

Okay updates - We are now on Day 32 of Max's Tripawd Journey

• Wound & Surgery Recovery - Right on schedule Max received a positive check on his surgery incision and was approved to take the cone off on Nov 18. It was a big day for us as it was also the first day he did the full walk down the block. He was delighted to be cone free and start to get back to his routine. We had just recently moved out of the basement the Friday before (Nov 15) because he was sleeping through the night without issue at that point. Thank you again for all the guidance about medications; getting that right helped all of us sleep more soundly.
• Diagnosis - Unfortunately on that same day we got the exciting news about his surgery recovery, we did get his diagnosis. They confirmed it is osteosarcoma and reminded us about the 8-12 month (with chemo) prognosis. It was a real tough day letting the gravity of that set in. 
• Chemo - Max had his first chemo appointment just a few days after getting his diagnosis on Friday Nov 22. He was very sleepy and slow moving for the rest of that day and into the next. He is off other meds at this point, only taking gabapentin as needed. The Saturday morning after his treatment he had a bit of an upset stomach and was not interested in eating, so we gave him the anti nausea med our vet prescribed. The sluggishness and tummy troubles faded quickly over the next few days, and he really started to get back to himself that week and following weekend. His next chemo visit is scheduled for next Friday 12/13.
• Energy and Mobility - After he got past the initial side effects of chemo, Max has been thriving and really getting back to his old self. He has fully mastered the stairs in our house at this point, and we are easing back into his pre-surgery walking routine. Of course the walks are MUCH shorter now, but we are trying to give him back as much of his routines as possible. And this morning he used the ramp to get into our bed all on his own for the first time! We are trying to convince him to take it slow, but he is ready to bound right back to business as usual. 
• Rehab - Max is ready to run and get back to his long walks he used to do. We want to move slowly and be careful with him, so we are now in the process of identifying a rehab practice to give us advice about how best to pace his recovery. I'll share more updates on that as we have them. 

Having Max off all of the surgery recovery meds and having him back to his spirited social self has been a really big step for all of us. We know we still have a lot of road ahead to figure out, but it feels great to have the surgery, diagnosis, and first chemo visit behind us. Now we are looking forward to visiting Max's grandpawrents and their very big farm for Christmas. It's a big car ride to get through, but the reward of exploring the farm and seeing his larger extended family is going to be the biggest treat for Max. 

Thanks for all the support and encouragement! We had our second chemo treatment this morning, and his white blood cell count was low, but just above the minimum to still receive treatment. We proceeded today, but we will be keeping a very close eye on him over the next few days. His next treatment is scheduled for three weeks from now, so we are hoping his counts come back up before then. Our vet let us know that if it is still low that she would rather push the treatment back a few days than lower the dosage. We are crossing our fingers that his counts are higher by the time we get to our next appointment. 

Of course, Max has no idea about his counts and isn't letting anything slow him down. He was so energetic and rowdy this morning that it took a while for the techs to be able to successfully set up the line for his chemo. They recommended we medicate in the morning the next time before we bring him to help with the jitters. We appreciated them clarifying that it was okay to still give him the gab or ace before chemo and plan to do exactly as they recommend before the next visit.

It was a big morning for him with a car ride, visit to the vet with so many dogs and people, and the chemo, so Max is now peacefully snoozing on the couch next to me. 

Finding time to get all three of us to the vet for chemo appointments and the tech checks has been a bit of a challenge, especially during the holiday season. We prioritized keeping his chemo on schedule, and I'm happy to share that we were able to schedule his first rehab visit for the second week in January. We are looking forward to getting some good information and exercises to help Max make the most of tripawd life.

We do have a big few weeks leading up to that rehab appointment, including going to visit extended family in Alabama. They let us know that the floors are mostly hardwood without many rugs. I'm nervous about Max slipping since he struggles with that in our house even with a ton of rugs. Do you have any suggestions for ways to help him with not slipping? He hates clothes/shoes, but our current plan is to pack and bring down a bunch of smaller rugs with us. 

I would also appreciate any advice about monitoring his activity. We are staying with family on a big farm, and I know Max is going to want to run free for hours. What range of activity should I keep in mind for him? Distance, time? If I let him do I whatever he wants, he will run himself ragged.

Thank you for all the help and we will keep you updated!

I'm not sure exactly how to start this update. Things have shifted for our little family quite a bit since our last post. Max did go to Alabama for Christmas, and he had a wonderful time. He got to roam on a farm, play with other doggies, and get covered in love from his family. 

Towards the end of the holiday trip, we noticed Max yelping every now and then. Once we returned, we realize he was favoring his front right leg and yelping. It would come and go, so we tried to chalk it up to maybe pushing it too hard on his big trip for Christmas. We had friends over for New Years Eve, and he was very playful with them. On New Years Day he was favoring the front right paw so much he was having trouble walking. We were really scared and nervous, so we took him into the urgent care vet at our veterinary hospital. 

He gets pretty anxious at the vet these days, so we gave him an acepromazine before going to the urgent care. They took a look but said they couldn't see anything wrong, that he walked like a three-legged dog, and most likely just over did it over the holidays. They reassured us by telling us that osteosarcoma spreads from one bone to another bone less than 10% of the time. They told us to rest him and start him back on carprofen to help with the pain. That was on Wed and we had another chemo appointment that Friday. His white blood cell levels were too low for chemo that day, but we told our oncologist about the front right leg pain. She again said it was likely a soft tissue injury because of the low chance of spread from one leg to another, but offered to do xrays before his next chemo (rescheduled for the following Wed) to offer peace of mine. 

We had our xray appointment Wednesday of this week 1/8, and we got the bad news we had been dreading. The cancer did spread to his front right shoulder and there are also small nodules in his lungs. We feel like our world is upside down all over again. We were so excited to do one last trip with Max after his recovery from surgery where he could be in the woods again and go on nature walks, maybe even run in a field again. 

Our doctor gave us the option of trying oral chemo, Palladia, at home, and we are going to give it a shot. The goal is to try to slow the cancer down just a little longer so we can give him a few more beautiful days doing what he loves the most. We are of course keeping a very close eye on his pain. We are continuing with 1/2 carprofen every 12 hours, 1 100mg gabapentin 2-3x/day as needed, and Tylenol 3 at night to help him sleep. 

We are doing our best to enjoy this time we all have together, but we are definitely struggling with the heartbreak of it all. Any advice on grappling with the grief would be appreciated.